AVERA QUEEN OF PEACE (NPI# 1154324507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154324507 |
| Entity Type | Organization |
| Organization Name | AVERA QUEEN OF PEACE |
| Other Organization Name | AVERA QUEEN OF PEACE HOSPITAL |
| Practice Address |
525 N Foster St Mitchell SD 57301-2966 |
| Practice Telephone | 6059952000 |
| Practice Fax Number | 6059952441 |
| Mailing Telephone | 6059952000 |
| Mailing Fax Number | 6059952441 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | DOUGLAS EKEREN (PRESIDENT/CEO) |
| Authorized Official Telephone | 6056688322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
10552 | SD | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | RR MEDICARE | CR0890 | 01 |
| SD | 0100130 | 05 | |
| SD | MEDICAID OUTPATIENT | 5500130 | 01 |
| Other Name | Type Code |
|---|---|
| Avera Queen of Peace Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568986040 | Avera Queen of Peace | Internal Medicine | 605 N Foster St Ste 100, Mitchell, SD 57301-2902 | 2017-07-27 |
| 1689051682 | Avera Queen of Peace | Clinic/Center | 409 S Ohlman St, Mitchell, SD 57301-3106 | 2015-04-29 |
| 1649577297 | Avera Queen of Peace | Clinic/Center | 1900 Grassland Dr., Mitchell, SD 57301-6205 | 2011-02-17 |
| 1053557967 | Avera Queen of Peace | Physician Assistant | 115 Second St Se, De Smet, SD 57231-0463 | 2008-12-23 |
| 1699972422 | Avera Queen of Peace | Specialist | 625 N Foster St Ste 200, Mitchell, SD 57301-2968 | 2007-06-27 |
| 1992712921 | Avera Queen of Peace | Pharmacy | 609 1st St Ne, Wessington Springs, SD 57382-2136 | 2006-08-02 |
| 1932105046 | Avera Queen of Peace | Clinic/Center | 265 Main Street, Corsica, SD 57328 | 2005-06-23 |
| 1326043092 | Avera Queen of Peace | Clinic/Center | 213 South Main, Howard, SD 57349 | 2005-06-17 |
| 1316942204 | Avera Queen of Peace | Clinic/Center | 604 1st St Ne, Wessington Springs, SD 57382-2134 | 2005-06-16 |
| 1639174568 | Avera Queen of Peace | Clinic/Center | 741 S Hill St, Salem, SD 57058-8761 | 2005-06-16 |
| Street Address |
525 N FOSTER ST |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-2966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831752393 | Avera Queen of Peace | Preventive Medicine | 525 N Foster St, Mitchell, SD 57301-2966 | 2019-04-19 |
| 1609358035 | Rachel Dykstra | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-09-01 |
| 1598241820 | Sarah Lynne Bauer | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-07-19 |
| 1053827634 | Avera Queen of Peace | Radiology | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-19 |
| 1821504515 | Mollie Jo Loes | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-18 |
| 1669987137 | Karen Faye Klinkner | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1295240786 | Katherine Caroline Thomsen | Dietitian, Registered | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-12-06 |
| 1205359031 | Avera Queen of Peace | Hospitalist | 525 N Foster St, Mitchell, SD 57301-2966 | 2017-07-24 |
| 1669822946 | Jenna Bortnem | Physical Therapist | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-06-16 |
| 1356799316 | Avera Home Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053653667 | Indian Health Service | General Acute Care Hospital | 26045 U.S. Hwy 18, Rosebud, SD 57570-0400 | 2013-03-21 |
| 1588909410 | Rosebud Ihs Hospital | General Acute Care Hospital | Hiway 18 Soldier Creek Road, Rosebud, SD 57570-0400 | 2012-12-04 |
| 1497046767 | Ihs Eagle Butte | General Acute Care Hospital | 317 S. Main St., Eagle Butte, SD 57625-1012 | 2011-04-21 |
| 1104060128 | Oglala Sioux Tribe Otitis Media | General Acute Care Hospital | 18 East Highway Ihs, Pine Ridge, SD 57770-1201 | 2009-04-21 |
| 1184886046 | Leola School District 44-2 | General Acute Care Hospital | 820 Leola Ave, Leola, SD 57456-0350 | 2008-07-01 |
| 1063630853 | Eagle Butte Indian Health Service | General Acute Care Hospital | 330 Maple Street, 326, Eagle Butte, SD 57625-1012 | 2007-04-24 |
| 1699175539 | Terry Sperling | General Acute Care Hospital | 1440 N Main St, Spearfish, SD 57783-1505 | 2014-08-28 |
| 1063811354 | Indian Health Service | General Acute Care Hospital | 24276 Airport Rd, Eagle Butte, SD 57625 | 2014-08-22 |
| 1275802241 | Rosebud Indian Health Service Hospital | General Acute Care Hospital | 400 Soldier Creek Rd, Rosebud, SD 57570-0400 | 2011-12-21 |
| 1003045345 | Indian Health Services | General Acute Care Hospital | 317 Main St, Eagle Butte, SD 57625 | 2009-07-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.